Section 17-1737-34 - Utilization control for NFs(a) This section defines the utilization control process which shall be administered in accordance with state and federal regulations to achieve optimal quality control of the utilization of services provided under the state plan.(b) The provisions for utilization control are as follows:(1) Providers of NF services shall admit only those recipients whose health care needs may be met by the facility;(2) Each resident shall receive the necessary nursing, medical and psychosocial services to attain and maintain the highest possible mental and physical functional status, as defined by the comprehensive resident assessment and plan of care;(3) The NF shall operate and provide services in compliance with all state, federal, and local laws, regulations, and codes and with accepted professional standards and principles that apply to professionals providing services in the NF;(4) The services provided by or arranged by the NF shall meet professional standards of quality and be provided by qualified persons in accordance with each resident's written plan of care; and(5) The following requirements regarding nurse aides shall be met: (A) A nursing facility shall not use any individual working in the facility as a nurse aide for more than four months unless the individual: (i) Has completed a nurse aide training and competency evaluation program certified by the State; and(ii) Is competent to provide such services;(B) A nursing facility shall provide for individuals used as nurse aides a nurse aide training competency and evaluation program certified by the State and such preparation as may be necessary to complete such a program;(C) A nursing facility shall not permit an individual to serve as a nurse aide or provide services of a type for which the individual has not demonstrated competency. A nursing facility shall not use such an individual as a nurse aide unless the facility has inquired of the state registry as to information in the registry concerning the individual;(D) A nursing facility shall not use any individual as a nurse aide if there has been a period of twenty-four consecutive months during which no nursing or nursing-related services were performed by the individual for monetary compensation. Such individual will need to complete a new training and competency evaluation program;(E) A nursing facility shall provide regular performance reviews and regular inservice education to assure that individuals used as nurse aides are competent to perform services as nurse aides, including training for individuals providing nursing and nursing-related services to residents with cognitive impairments;(F) Any findings of abuse or neglect of residents or misappropriations of residents' property by nurse aides shall be reported to the state department of health; and(G) The State shall: (i) Establish and maintain a registry of all individuals who have satisfactorily completed a nurse aide training and competency evaluation program certified by the State;(ii) The registry shall include specific documented findings by the State of resident neglect or abuse or misappropriation of resident property as well as any brief statement of the individual disputing the findings; and(iii) When inquiries to the registry are made concerning an individual listed in the registry, any information disclosed concerning such a finding shall also include disclosure of any such statement in the registry relating to the finding or a clear and accurate summary of such a statement.Haw. Code R. § 17-1737-34
[Eff 08/01/94, am 08/25/07 ] (Auth: HRS § 346-14; 42 U.S.C. §§1395, 1396; Pub. L. No. 100-203; 42 C.F.R. §§431.10, 435.1009, 456.1, 483.1 ) (Imp: Pub. L. No. 100-203; 42 C.F.R. §§435.1009, 442.1, 456.1, 456.250, 483.1, 483.20, 483.25, 483.75 )